An epidemiological scoring system for tooth wear and dental erosive wear

Background: The prevalence and severity of tooth wear and dental erosion is rising in children and there is no consensus about an index to be employed. Aim: To assess the reliability of an epidemiological scoring system dental wear index (DWI) to measure tooth wear and dental erosive wear. Design: An epidemiological cross-sectional survey was conducted to evaluate and compare tooth wear and dental erosion using the dental wear index and erosion wear index (EWI). The study was conducted with randomised samples of 2,371 children aged between 4 years and 12 years selected from the State of São Paulo, Brazil. Records were used for calculating tooth wear and dental erosion; the incisal edge and canine cusp were excluded. Results: As the schoolchildren's ages increased the severity of primary tooth wear increased in canines (P = 0.0001, OR = 0.34) and molars (P = 0.0001, OR = 2.47) and erosion wear increased in incisal/occlusal (P = 0.0001, OR = 5.18) and molars (P = 0.0001, OR = 2.47). There was an increased prevalence of wear in the permanent teeth of older schoolchildren, particularly on the incisal/occlusal surfaces (P = 0.0001, OR = 7.03). Conclusion: The prevalence of tooth wear and dental erosion increased as age increased in children. The epidemiological scoring system Dental Wear Index is able to measure both tooth wear and dental erosive wear. This index should be used to monitor the progression of non-carious lesions and to evaluate the levels of disease in the population.

The effect of CCL3 and CCR1 in bone remodeling induced by mechanical loading during orthodontic tooth movement in mice

Bone remodeling is affected by mechanical loading and inflammatory mediators, including chemokines. The chemokine (C–C motif) ligand 3 (CCL3) is involved in bone remodeling by binding to C–C chemokine receptors 1 and 5 (CCR1 and CCR5) expressed on osteoclasts and osteoblasts. Our group has previously demonstrated that CCR5 down-regulates mechanical loading-induced bone resorption. Thus, the present study aimed to investigate the role of CCR1 and CCL3 in bone remodeling induced by mechanical loading during orthodontic tooth movement in mice. Our results showed that bone remodeling was significantly decreased in CCL3−/− and CCR1−/− mice and in animals treated with Met-RANTES (an antagonist of CCR5 and CCR1). mRNA levels of receptor activator of nuclear factor kappa-B (RANK), its ligand RANKL, tumor necrosis factor alpha (TNF-α) and RANKL/osteoprotegerin (OPG) ratio were diminished in the periodontium of CCL3−/− mice and in the group treated with Met-RANTES. Met-RANTES treatment also reduced the levels of cathepsin K and metalloproteinase 13 (MMP13). The expression of the osteoblast markers runt-related transcription factor 2 (RUNX2) and periostin was decreased, while osteocalcin (OCN) was augmented in CCL3−/− and Met-RANTES-treated mice. Altogether, these findings show that CCR1 is pivotal for bone remodeling induced by mechanical loading during orthodontic tooth movement and these actions depend, at least in part, on CCL3.

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher’s LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.

Cigarette smoke inhalation influences bone healing of post-extraction tooth socket: a histometric study in rats

The aim of this study was to evaluate, histometrically, the bone healing of the molar extraction socket just after cigarette smoke inhalation (CSI). Forty male Wistar rats were randomly assigned to a test group (animals exposed to CSI, starting 3 days before teeth extraction and maintained until sacrifice; n=20) and a control group (animals never exposed to CSI; n=20). Second mandibular molars were bilaterally extracted and the animals (n=5/group/period) were sacrificed at 3, 7, 10 and 14 days after surgery. Digital images were analyzed according to the following histometric parameters: osteoid tissue (OT), remaining area (RA), mineralized tissue (MT) and non-mineralized tissue (NMT) in the molar socket. Intergroup analysis showed no significant differences at day 3 (p>0.05) for all parameters. On the 7th day, CSI affected negatively (p<0.05) bone formation with respect to NMT and RA (MT: 36%, NMT: 53%, RA: 12%; and MT: 39%, NMT: 29%, RA: 32%, for the control and test groups, respectively). In contrast, no statistically significant differences (p>0.05) were found at days 10 and 14. It may be concluded that CSI may affect socket healing from the early events involved in the healing process, which may be critical for the amount and quality of new-bone formation in smokers.

Healing of a tooth with an overinstrumented apex, extensive transportation and periapical lesion using a 5 mm calcium hydroxide apical plug: an 8-year follow-up report

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.

Induced tooth movement: standardization of terms to describe the effects of forces on the periodontal ligament: compression/Traction instead of Pressure/Tension

There is no reason for Dentistry to use different terms for phenomena defined in Physics, the specific field in which concepts associated with forces are established and adapted. In place of pressure/tension, the compression/traction pair should be used. This study defines each one of these terms and justifies their use. Our contemporary world demands standardized criteria, methods, measures, concepts and terms to ensure that study protocols, results and applications are used in the same way in any country or area of human action.

A uniqueness theorem for the determination of sources in the Germain–Lagrange plate equation

We prove a uniqueness result related to the Germain–Lagrange dynamic plate differential equation. We consider the equation {∂2u∂t2+△2u=g⊗f,in ]0,+∞)×R2,u(0)=0,∂u∂t(0)=0, where uu stands for the transverse displacement, ff is a distribution compactly supported in space, and g∈Lloc1([0,+∞)) is a function of time such that g(0)≠0g(0)≠0 and there is a T0>0T0>0 such that g∈C1[0,T0[g∈C1[0,T0[. We prove that the knowledge of uu over an arbitrary open set of the plate for any interval of time ]0,T[]0,T[, 0

Lamb mode diversity imaging fornon-destructivetesting of plate-likestructures

Several Lamb wave modes can be coupled to a particular structure, depending on its geometry and transducer used to generate the guided waves. Each Lamb mode interacts in a particular form with different types of defects, like notches, delamination, surface defects, resulting in different information which can be used to improve damage detection and characterization. An image compounding technique that uses the information obtained from different propagation modes of Lamb waves for non-destructive testing of plate-like structures is proposed. A linear array consisting of 16 piezoelectric elements is attached to a 1 mm thickness aluminum plate, coupling the fundamental A0 and SO modes at the frequencies of 100 kHz and 360 kHz, respectively. For each mode two images are obtained from amplitude and phase information: one image using the Total Focusing Method (TFM) and one phase image obtained from the Sign Coherence Factor (SCF). Each TFM image is multiplied by the SCF image of the respective mode to improve contrast and reduce side and grating lobes effects. The high dispersive characteristic of the A0 mode is compensated for adequate defect detection. The information in the SCF images is used to select one of the TFM mode images, at each pixel, to obtain the compounded image. As a result, dead zone is reduced, resolution and contrast are improved, enhancing damage detection when compared to the use of only one mode. (C) 2013 Elsevier Ltd. All rights reserved. (AU)

Geological and Structural evolution of the Eurasia Africa plate boundary in the Gulf of Cadiz Central Eastern Atlantic Sea.

Iberia Africa plate boundary, cross, roughly W-E, connecting the eastern Atlantic Ocean from Azores triple junction to the Continental margin of Morocco. Relative movement between the two plate change along the boundary, from transtensive near the Azores archipelago, through trascurrent movement in the middle at the Gloria Fracture Zone, to transpressive in the Gulf of Cadiz area. This study presents the results of geophysical and geological analysis on the plate boundary area offshore Gibraltar. The main topic is to clarify the geodynamic evolution of this area from Oligocene to Quaternary. Recent studies have shown that the new plate boundary is represented by a 600 km long set of aligned, dextral trascurrent faults (the SWIM lineaments) connecting the Gloria fault to the Riff orogene. The western termination of these lineaments crosscuts the Gibraltar accretionary prism and seems to reach the Moroccan continental shelf. In the past two years newly acquired bathymetric data collected in the Moroccan offshore permit to enlighten the present position of the eastern portion of the plate boundary, previously thought to be a diffuse plate boundary. The plate boundary evolution, from the onset of compression in the Oligocene to the Late Pliocene activation of trascurrent structures, is not yet well constrained. The review of available seismics lines, gravity and bathymetric data, together with the analysis of new acquired bathymetric and high resolution seismic data offshore Morocco, allows to understand how the deformation acted at lithospheric scale under the compressive regime. Lithospheric folding in the area is suggested, and a new conceptual model is proposed for the propagation of the deformation acting in the brittle crust during this process. Our results show that lithospheric folding, both in oceanic and thinned continental crust, produced large wavelength synclines bounded by short wavelength, top thrust, anticlines. Two of these anticlines are located in the Gulf of Cadiz, and are represented by the Gorringe Ridge and Coral Patch seamounts. Lithospheric folding probably interacted with the Monchique – Madeira hotspot during the 72 Ma to Recent, NNE – SSW transit. Plume related volcanism is for the first time described on top of the Coral Patch seamount, where nine volcanoes are found by means of bathymetric data. 40Ar-39Ar age of 31.4±1.98 Ma are measured from one rock sample of one of these volcanoes. Analysis on biogenic samples show how the Coral Patch act as a starved offshore seamount since the Chattian. We proposed that compression stress formed lithospheric scale structures playing as a reserved lane for the upwelling of mantle material during the hotspot transit. The interaction between lithospheric folding and the hotspot emplacement can be also responsible for the irregularly spacing, and anomalous alignments, of individual islands and seamounts belonging to the Monchique - Madeira hotspot.

Geochronology, geochemistry and isotopic compositions of the volcanic rocks from oceanic (Hawaii) and continental (Eifel) intra-plate environments

The Eifel volcanism is part of the Central European Volcanic Province (CEVP) and is located in the Rhenish Massif, close to the Rhine and Leine Grabens. The Quaternary Eifel volcanism appears to be related to a mantle plume activity. However, the causes of the Tertiary Hocheifel volcanism remain debated. We present geochronological, geochemical and isotope data to assess the geotectonic settings of the Tertiary Eifel volcanism. Based on 40Ar/39Ar dating, we were able to identify two periods in the Hocheifel activity: from 43.6 to 39.0 Ma and from 37.5 to 35.0 Ma. We also show that the pre-rifting volcanism in the northernmost Upper Rhine Graben (59 to 47 Ma) closely precede the Hocheifel volcanic activity. In addition, the volcanism propagates from south to north within the older phase of the Hocheifel activity. At the time of Hocheifel volcanism, the tectonic activity in the Hocheifel was controlled by stress field conditions identical to those of the Upper Rhine Graben. Therefore, magma generation in the Hocheifel appears to be caused by decompression due to Middle to Late Eocene extension. Our geochemical data indicate that the Hocheifel magmas were produced by partial melting of a garnet peridotite at 75-90 km depth. We also show that crustal contamination is minor although the magmas erupted through a relatively thick continental lithosphere. Sr, Nd and Pb isotopic compositions suggest that the source of the Hocheifel magmas is a mixing between depleted FOZO or HIMU-like material and enriched EM2-like material. The Tertiary Hocheifel and the Quaternary Eifel lavas appear to have a common enriched end-member. However, the other sources are likely to be distinct. In addition, the Hocheifel lavas share a depleted component with the other Tertiary CEVP lavas. Although the Tertiary Hocheifel and the Quaternary Eifel lavas appear to originate from different sources, the potential involvement of a FOZO-like component would indicate the contribution of deep mantle material. Thus, on the basis of the geochemical and isotope data, we cannot rule out the involvement of plume-type material in the Hocheifel magmas. The Ko’olau Scientific Drilling Project (KSDP) has been initiated in order to evaluate the long-term evolution of Ko’olau volcano and obtain information about the Hawaiian mantle plume. High precision Pb triple spike data, as well as Sr and Nd isotope data on KSDP lavas and Honolulu Volcanics (HVS) reveal compositional source variations during Ko’olau growth. Pb isotopic compositions indicate that, at least, three Pb end-members are present in Ko’olau lavas. Changes in the contributions of each component are recorded in the Pb, Sr and Nd isotopes stratigraphy. The radiogenic component is present, at variable proportion, in all three stages of Ko’olau growth. It shows affinities with the least radiogenic “Kea-lo8” lavas present in Mauna Kea. The first unradiogenic component was present in the main-shield stage of Ko’olau growth but its contribution decreased with time. It has EM1 type characteristics and corresponds to the “Ko’olau” component of Hawaiian mantle plume. The second unradiogenic end-member, so far only sampled by Honololu lavas, has isotopic characteristics similar to those of a depleted mantle. However, they are different from those of the recent Pacific lithosphere (EPR MORB) indicating that the HVS are not derived from MORB-related source. We suggest, instead, that the HVS result from melting of a plume material. Thus the evolution of a single Hawaiian volcano records the geochemical and isotopic changes within the Hawaiian plume.

Observable stages and scheduling for alveolar remodeling following antemortem tooth loss

Zahnverlust zu Lebzeiten („antemortem tooth loss“, AMTL) kann als Folge von Zahnerkrankungen, Traumata, Zahnextraktionen oder extremer kontinuierlicher Eruption sowie als Begleiterscheinung fortgeschrittener Stadien von Skorbut oder Lepra auftreten. Nach dem Zahnverlust setzt die Wundheilung als Sekundärheilung ein, während der sich die Alveole mit Blut füllt und sich ein Koagulum bildet. Anschließend erfolgt dessen Umwandlung in Knochengewebe und schließlich verstreicht die Alveole derart, dass sie makroskopisch nicht mehr erkannt werden kann. Der Zeitrahmen der knöchernen Konsolidierung des Kieferkammes ist im Detail wenig erforscht. Aufgrund des gehäuften Auftretens von AMTL in menschlichen Populationen, ist die Erarbeitung eines Zeitfensters, mit dessen Hilfe durch makroskopische Beobachtung des Knochens die Zeitspanne seit dem Zahnverlust („time since tooth loss“, TSL) ermittelt werden kann, insbesondere im archäologischen Kontext äußerst wertvoll. Solch ein Zeitschema mit Angaben über die Variabilität der zeitlichen Abläufe bei den Heilungsvorgängen kann nicht nur in der Osteologie, sondern auch in der Forensik, der allgemeinen Zahnheilkunde und der Implantologie nutzbringend angewandt werden. rnrnNach dem Verlust eines Zahnes wird das Zahnfach in der Regel durch ein Koagulum aufgefüllt. Das sich bildende Gewebe wird rasch in noch unreifen Knochen umgewandelt, welcher den Kieferknochen und auch die angrenzenden Zähne stabilisiert. Nach seiner Ausreifung passt sich das Gewebe schließlich dem umgebenden Knochen an. Das Erscheinungsbild des Zahnfaches während dieses Vorgangs durchläuft verschiedene Stadien, welche in der vorliegenden Studie anhand von klinischen Röntgenaufnahmen rezenter Patienten sowie durch Untersuchungen an archäologischen Skelettserien identifiziert wurden. Die Heilungsvorgänge im Zahnfach können in eine prä-ossale Phase (innerhalb einer Woche nach Zahnverlust), eine Verknöcherungsphase (etwa 14 Wochen nach Zahnverlust) und eine ossifizierte bzw. komplett verheilte Phase (mindestens 29 Wochen nach Zahnverlust) eingeteilt werden. Etliche Faktoren – wie etwa die Resorption des Interdentalseptums, der Zustand des Alveolarknochens oder das Individualgeschlecht – können den normalen Heilungsprozess signifikant beschleunigen oder hemmen und so Unterschiede von bis zu 19 Wochen verursachen. Weitere Variablen wirkten sich nicht signifikant auf den zeitlichen Rahmen des Heilungsprozesse aus. Relevante Abhängigkeiten zwischen verschiedenen Variabeln wurden ungeachtet der Alveolenauffüllung ebenfalls getestet. Gruppen von unabhängigen Variabeln wurden im Hinblick auf Auffüllungsgrad und TSL in multivariablen Modellen untersucht. Mit Hilfe dieser Ergebnisse ist eine grobe Einschätzung der Zeitspanne nach einem Zahnverlust in Wochen möglich, wobei die Einbeziehung weiterer Parameter eine höhere Präzision ermöglicht. rnrnObwohl verschiedene dentale Pathologien in dieser Studie berücksichtigt wurden, sollten zukünftige Untersuchungen genauer auf deren potenzielle Einflussnahme auf den alveolaren Heilungsprozess eingehen. Der kausale Zusammenhang einiger Variablen (wie z. B. Anwesenheit von Nachbarzähnen oder zahnmedizinische Behandlungen), welche die Geschwindigkeit der Heilungsrate beeinflussen, wäre von Bedeutung für zukünftige Untersuchungen des oralen Knochengewebes. Klinische Vergleichsstudien an forensischen Serien mit bekannter TSL oder an einer sich am Anfang des Heilungsprozesses befindlichen klinischen Serie könnten eine Bekräftigung dieser Ergebnisse liefern.

Symptomatic plate removal after treatment of facial fractures

AIMS: To identify the rates and reasons for plate removal (PR) among patients treated for facial fractures. MATERIALS AND METHODS: A retrospective review of files of 238 patients. RESULTS: Forty-eight patients (20.2%) had plates removed. The reason for removal was objective in 33.3% and subjective in 29.2%. The most common subjective reason was cold sensitivity, and the most common objective reason was wound dehiscence/infection. Women had PR for subjective reasons more often than men (p=0.018). Removal was performed more often for subjective reasons after zygomatico-orbital fractures than after mandibular fractures (p=0.002). Plates inserted in the mandible from an intraoral approach were removed more frequently than extraorally inserted mandibular plates, intraorally inserted maxillary plates, and extraorally inserted plates in other locations (p<0.001). Orbital rim plates had a higher risk of being removed than maxillary or frontal bone plates (p=0.02). CONCLUSIONS: Subjective discomfort is a notable reason for PR among Finnish patients, suggesting that the cold climate has an influence on the need for removal. Patients receiving mandibular osteosynthesis with miniplates from an intraoral approach are at risk of hardware removal because of wound dehiscence/infection and loose/broken hardware, reminding us that more rigid fixation devices should not be forgotten despite the widespread use of miniplates.

Significance of Periodontal Risk Assessment in the recurrence of periodontitis and tooth loss

Aim: To investigate the association of the Periodontal Risk Assessment (PRA) model categories with periodontitis recurrence and tooth loss during supportive periodontal therapy (SPT) and to explore the role of patient compliance. Material and Methods: In a retrospective cohort, PRA was performed for 160 patients after active periodontal therapy (APT) and after 9.5 ± 4.5 years of SPT. The recurrence of periodontitis and tooth loss were analysed according to the patient's risk profile (low, moderate or high) after APT and compliance with SPT. The association of risk factors with tooth loss and recurrence of periodontitis was investigated using logistic regression analysis. Results: In 18.2% of patients with a low-risk profile, in 42.2% of patients with a moderate-risk profile and in 49.2% of patients with a high-risk profile after APT, periodontitis recurred. During SPT, 1.61 ± 2.8 teeth/patient were lost. High-risk profile patients lost significantly more teeth (2.59 ± 3.9) than patients with moderate- (1.02 ± 1.8) or low-risk profiles (1.18 ± 1.9) (Kruskal–Wallis test, p=0.0229). Patients with erratic compliance lost significantly (Kruskal–Wallis test, p=0.0067) more teeth (3.11 ± 4.5) than patients compliant with SPT (1.07 ± 1.6). Conclusions: In multivariate logistic regression analysis, a high-risk patient profile according to the PRA model at the end of APT was associated with recurrence of periodontitis. Another significant factor for recurrence of periodontitis was an SPT duration of more than 10 years.

Immunohistochemical localization of osteoclastogenic cell mediators in feline tooth resorption and healthy teeth

Tooth resorption is among the most common and most challenging problems in feline dentistry It is a progressive disease eventually leading to tooth loss and often root replacement. The etiology of moth resorption remains obscure and to date no effective therapeutic approach is known. The present study is aimed at assessing the reliability of radiographic imaging and addressing the possible involvement of receptor activator of NF kappa B (RANK), its ligand (RANKL), and osteoprotegerin (OPG) in the process of tooth resorption. Teeth from 8 cats were investigated by means of radiographs and paraffin sections followed by immunolabeling. Six cats were diagnosed with tooth resorption based on histopathologic and radiographic findings. Samples were classified according to a four-stage diagnostic system. Radiologic assessment of tooth resorption correlated very strongly with histopathologic findings. Tooth resorption was accompanied by a strong staining with all three antibodies used, especially with anti-RANK and anti-RANKL antibodies. The presence of OPG and RANKL at the resorption site is indicative of repair attempts by fibroblasts and stromal cells. These findings should be extended by further investigations in order to elucidate the pathophysiologic processes underlying tooth resorption that might lead to prophylactic and/or therapeutic measures. J Vet Dent 27(2); 75 - 83, 2010